A recurring hesitation from patients is how we assess them if we can’t touch them. I have created my first thread here around ideas to add more value to Telehealth consultations in view of this barrier. https://twitter.com/myscoreit/status/1252527089988841480

Informed consent and create expectations around what will happen , what information you will be looking for, that this is not face to face but the same “rules” apply.

When you examine, use more words. Explain what you are seeing, looking for eg “i am checking your strength”, “I am going to talk you through a slump test”

Ask the patient to send in photos of their swelling, etc. before the visit or they can also share them in the platform if it allows. This week a patient sent me his concerns about swelling under the MTPJ2, which was just callous.

Ask the patient to Mark with a pen where it is sore ear, this is helpful as you guide them through self palpating.

Demonstrate and explain your movement requests. Remember to use two planes, front and side on if it helps the patient to understand .

Use digital forms of your existing tools. I have saved some screen shots of anatomy images to share on screen

Think outside the box. I was speaking with a patient about sugar. ( we do all sorts of things @ACSEP_ !) I had a can of corn (all I could find at the time) and I held up the food label to the Camera and we talked through the things to look out for.

Use digital platforms that support you care- there are many apps, exercise tools that help you prescribe exercise from behind your monitor.

Think of ways to keep in you much remotely- you could use sms, many exercise platforms have built in reminders your can see, use patient reported outcome surveys to monitor the progress between it after episodes of care

This thread follows my recent blog @myscoreit because we find automated PROM collection not only adds value to your patient, makes you stand out as being accountable, but helps you monitor them remotely, reaching out I’d concerned. I saw new instability in an ACL pt this way.